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Am Fam Physician. 2000;61(1):50

to the editor: I just finished reading the article “Chronic Abdominal Pain in Childhood: Diagnosis and Management”1 and would like to add one other rare and treatable condition to the list of specific disease states associated with abdominal pain. Many years ago, I had a patient who presented with recurrent abdominal pain. The young man underwent many complete blood counts and other tests, but no conclusions were reached as to a specific diagnosis. One night I was reading an article about abdominal epilepsy, and it could have been written with this young man in mind. All of the symptoms fit perfectly.

I ordered an electroencephalogram on the patient, and the results were positive for epilepsy. The patient was started on phenytoin (Dilantin) and did not have another attack as long as I was able to follow him. I knew that abdominal epilepsy was rare because our local neurologist called me and asked if he could see the patient. He had trained at Cleveland Clinic and had never seen such a case. Of course, I obliged. The family has since moved away, and I lost touch with them. I thought it would be wise to include this diagnosis as a “last resort” consideration.

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